Two cases of long lasting bacteremia due to Mycobacetrium avium complex despite new macrolides-containing regimens in patients with acquired immunodeficiency syndrome

The prognosis of Mycobacterium avium complex (MAC) infection has been impro ved by new macrolides-containing regimens and the use of highly active anti retroviral therapy (HAART) in the treatment of acquired immunodeficiency sy ndrome (AIDS), We report on two AIDS cases with long lasting bacteremia due to MAC under this regimen. Both patients experienced problems due to side effects from the anti-MAC regimen and from an immunereconstitution syndrome related to HAART. MAC infection persisted despite treatment, however, no a nti-MAC drug-resistant isolates emerged throughout the clinical course in e ither case. These cases demonstrate that therapy for disseminated MAC infec tion is sometimes difficult even with HAART and macrolides-containing regim ens.